HomeMy WebLinkAboutPermit Electrical 1999-1-21
;:~i~~'oa~~gd~rOject as su~mitted has the following -
225 FIFTH STREET approv'al. es not reqUIre specific land use ELECTRICAL PERMIT APPLICATION
SPRINGFIELD, OREGON 97477 Zoning ~
INSPECTION REQUEST: 776-3769
OFFICE: 726-3759 Date ., - .)../- f1 j
Au.thorizedBfoi na / %..J. COMPLETE FEE SCHEDULE BELOY
1. LOC~T,l;,ON O~INS:rALJ.A.TION
8 'to {/;:;J..eA<f1/;.,.1L . A. New Residential-Single or
Multi-Family per dwelling unit.
Service Included:
JOB DESCRIPTION .-;-/ 1000 sq. ft. or less
T ~ IV t4 pr ,;p:~,4Jr>> t/ e 4z e~/ Each add it i onal 500
v . sq. ft or portion
Permits are non-transferable and expire {,~~&hereOf
if work is not started within 180 days ~ ~#o anuf'd Home, or
of iss~ance or if work is suspended for0 O~~Cqt.(M44uavrePwelling
180 days. 00 O~1y 9./~Vg'o.8t. ~~I] fqeeder
'BO. }j '5<-00 el]ter ~(j by I1r r~q. ,
2. CONTRACTOR INSTALLATION ONLY I] Cq/~ ~9JfflJ;JJi~ ~s i'<<er;J;.'et1:J$ V.
lJ'hb '{} tf}~€s~J,'Rt!4f?#/lJ~rJ9(J}i'tt:!e
Electrical Contractor ..L~;Ttfjj ~( erfor~elfllteJ.W~.~~~~O qres 'fi/ify
. (/ -. Cel]t. e Ore' (/vOt. les Of !.<II? 9s. et fo
Address /OD ( .SOJ Cola.. ~,th~ 5' f.; ~OO7_~'gf}ttJFt.~~ei:'<-00"}!1
~ .' 201 ~@~ ~'jt eJJJ9. ~s A:-
Cityt' C>r-t/i'/trD ef<.-Phone?.o/X..J-5/;? 401 amps;]<t~3. vf~. -y-
~ 601 amps to troo ikpp
Supervisor License Number ';;lGe.?!?;) Over 1000 amps/volts
/'A!Jf' Reconnec t 'Only
Expiration Date (6 / W
t~ C. Temporary Services or Feeders
Constr Contr. Number 9~ ;:L'YtlCI:. Installation, Alteration or Relocation
/ tt/S -.
Expiration Date 7/3/ tt '7 AI'7"1 ~ERM/'rSH. 200 amps"oT less $ 40.00
. " . IURIZE, 'A!!.M.Q1 amps to 400 amps $ 55.00.
Signature no. .;;;zpend~in lec~~;t..WJ DUIVDS.R"'6q>~fi.O.l- to 600 amps $ 80.00
. ANy iCED aD m"f~r '6()(1jSimw or 1000 volts see "B" above
. .:p'. r'?a.o..v, _ 11 IS.4 ^ PERM v~Rk'
~~ r. , " r':R10B. 8,.qB!ta.~~ tTi!$(4thts
Owners. e \ ~ . c: f:OR
Addr~s 5. \t New, Alteration or Extension Per Panel
One Circuit $ 35.00
City _ Phone Each Additional
Circuit or with Service DC>
o TALLATION or Feeder Permit. I ~ $ 2.00':z. V -
Miscellaneous (Service/feeder
-Each installation
Pump or irrigation
Sign/Outline Lighting
Limited Energy/Res
Limited Energy/Comm
~ity Job Number
\~fJ~41)
The installation is being made on
property I own which is not intended
for sale, lease or rent.
E.
Owners Signature:
DATE~----------I-:~t~~~~-f\\~ll~
RECEIPT #: (. J-:-I:-fy. \;U (J
RECEIVED BY: X-/l..1 I V -'..
L/ )v--t- '----""
SUBTOTAL OF ABOVE
5% State Surcharge
3% Administrative Fee
TOTAL
5.
Items
'j:J/5?7
Cost
Sum
$ 85.00
$ 15.00
.$ 40.00
$ 50.00
$ 60.00
$100.00
$130.00
$300.00
$ 40.00
.5C> ~
,.
not included)
$ 40.00
$ 40.00
$ 20.00
$ 3(fJ
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